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The stereotypes and gender barriers that stop men working in hospices

Caring, empathetic, kind and wise – such qualities fit our image of the ideal hospice nurse… so why is our image of that person overwhelmingly female?

Caring, empathetic, kind and wise – such qualities fit our image of the ideal hospice nurse… so why is our image of that person overwhelmingly female?


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Picture the ideal hospice nurse: warm, caring, empathetic and blessed with a knack for calming patients with words and touch. When caring for the dying, the hospice nurse manages pain, controls symptoms and tends carefully to existential suffering. Patients are healed with kindness and wisdom, even those who cannot be cured. This is the image of a hospice nurse.

But did you picture a man?

Unsettling statistics

As a man, a biomedical researcher and an aspiring physician at Stanford University in California, US, my answer would have been no. That is, until I began volunteering in a hospice – talking, laughing and crying with terminally ill patients under the tutelage of hospice nurses. These teachers were knowledgeable and steadfast, yet comforting and compassionate.

Most of these nurses were women. In the US, men comprise only 13% of all nurses (Munnich and Wozniak 2017). In the UK, that number drops to about 11% (Williams 2017). It is therefore unsurprising – although still unsettling – that my theoretical hospice nurse was not likely to be a man. No gender-specific archetype should exist for end of life nursing. Hospice work has taught me that men, like women, can embody our deepest values in caring for the dying.

Darryl (a pseudonym) is often the nurse on duty when I arrive at the hospice. He leads me in turning and repositioning patients, he describes their personalities and medical issues, and he empowers the caregiving team to do its multifaceted job. In many ways, Darryl reflects a promising trend in the US: an increase in male nurses and their cultural acceptance (Munnich and Wozniak 2017, Miller and Fremson 2018). What’s more, the diversity which he brings to hospice nursing as a male immigrant from south east Asia is important for our heterogeneous, ageing population (Phillips and Malone 2014).

Yet there are systemic and cultural barriers for people like Darryl. The UK and the US continue to face issues of stereotypes, attrition and gender identity while working to diversify their nursing populations (Stott 2004, Jones-Berry 2016). Such issues might be particularly acute in hospice nursing, where empathetic concern and perspective-taking – traits often ascribed to women – are especially important (Riggio and Taylor 2000). Most images of a hospice nurse remain resolutely female.

Subconscious stereotyping

I want to reiterate: countless women do, no doubt, embody the ideal hospice nurse. They communicate effectively, have medical wisdom and care unceasingly. But gender-specific archetypes are self-propagating, exacerbating pre-existing disparities. A fascinating New York Times article, Picture a Leader. Is She a Woman?, highlights this notion (Murphy 2018). Professionals worry that subconscious stereotyping might prevent promising young men from becoming the next Darryl. In turn, certain hospice patients may struggle to identify with their caregivers.

Hospice work has taught me that men, like women, can embody our deepest values in caring for the dying

This is the crux of the male nursing issue, in and outside of hospice care. As patients find themselves in more intimate clinical settings, they often show greater preference for same-sex nurses (Chur-Hansen 2002). And with our ageing Western nations, many men will eventually find themselves in the highly intimate context of the hospice.

Common ground

A man I cared for some months ago was dying of pancreatic cancer. He was in his sixties, ruggedly stern and an avid fan of American football. For weeks, hospice nurses provided top-notch care for him and his family. His pain was managed, his finances were taken care of and someone was always present for him. But the man was distant and reserved, usually watching sports in his room.

One day, in walked Darryl.

‘Hey, sir! How is the game going?’ he asked, pointing to the television. The man mumbled: ‘Not great.’ The two chuckled together, like long-lost friends. Darryl held the man’s hand as they discussed all the fears and joys surrounding that most human experience, death.

He, she, male, female – this is the image of a hospice nurse.


References

Chur-Hansen A (2002) Preferences for female and male nurses: the role of age, gender and previous experience – year 2000 compared with 1984

Jones-Berry S (2016) Stereotypes and cultural cringe still keeping men out of nursing

Miller C, Fremson R (2018) Forget about the stigma: male nurses explain why nursing is a job of the future for men

Munnich E, Wozniak A (2017) What Explains the Rising Share of U.S. Men in Registered Nursing? 

Murphy H (2018) Picture a leader. Is She a woman? 

Phillips J, Malone B (2014) Increasing racial/ethnic diversity in nursing to reduce health disparities and achieve health equity

Riggio R, Taylor S (2000) Personality and communication skills as predictors of hospice nurse performance 

Stott A (2004) Issues in the socialisation process of the male student nurse: implications for retention in undergraduate nursing courses

Williams R (2017) Why are there so few male nurses? 


Aldis Petriceks is anatomy scholar and research assistant at Stanford University School of Medicine, Stanford, California, United States

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